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Co-operation with State Boards of Health

January 5, 1912 — President’s Evening, General Federation of Women’s Clubs, San Francisco CA

 

Madam President and Ladies and Gentlemen:

We have striking examples of co-operation between state federations and state boards of health in the work in the State of Washington, which is known to us especially through the representatives here, Mrs. Ellis and Mrs. McEwen; and in the splendid work of my friend, Mrs. Crockett, as head of the Department of Health, in conjunction with the members of her committee located in the various states.

It is natural that state federations and state boards of health should co-operate. Many of our state boards have ideals of public health service which it is impossible for them to approach because of the lack of financial support and of the unintelligent and indifferent attitude of the average citizen. And just as Dr. Wiley has recognized the General Federation of Women’s Clubs as the organization without whose aid and support he could not have accomplished his great work, so some of the state boards of health look upon the state federation of women’s clubs as the one organization which appreciates their aims and is ready to give valuable help.

We have had, in the States of Kentucky and Minnesota, particularly notable examples of co-operation of this sort, and the President has asked me to tell you something about it tonight.

In the State of Kentucky, some three years ago (the state of our dear Mrs. Breckinridge, who had part in this work) I inspected sanitary conditions in twelve of the leading cities, under the joint auspices of the State Federation of Women’s Clubs and the State Board of Health, with the State Dairy and Food Commission and various other organizations co operating. In the fall of 1910 I made a similar campaign, under similar auspices, covering seventeen of the leading cities of Minnesota.

Under the general supervision of the State Federation, federated clubs in the various cities made all the local arrangements, collected and forwarded to me in advance certain required data, such as local ordinances bearing upon sanitation, the city charter, printed department reports and maps accurately market to show extension of water service, sewer service and outlets, parks and playgrounds. The clubs also collected, from city officials and other persons, signed replies to more than a hundred questions concerning their city’s in come, expenditures and resources; extent and value of present public improvements; details and cost of municipal administration in certain departments, and a great quantity of general statistical information which it was important for me to have before undertaking a personal study of local conditions. The women who have personally undertaken this part of the work have told me that it gave them invaluable insight into the problems of municipal administration; and I have always considered it .most important that the women should thus form acquaintance with their officials, and gain an insight into their difficulties before venturing any suggestions for improvements in the conduct of municipal housekeeping or other public affairs.

The State Boards of Health co-operated by furnishing me with the state laws bearing upon local sanitation and with all the state reports, etc.  by sharing the expense of the campaign, and by making me temporarily a health officer of the state (and I may mention that I was also sworn in as a local officer in many of the cities).

Each State Board published my report at the conclusion of the campaign.

On the tours of inspection I was accompanied by local (and sometimes state) officials, and by members of the board of education and various organizations such as the chamber of commerce and the medical association; and always by committees of the women’s clubs. We made first-hand studies of water supplies, sewer systems, street and alleysanitation, garbage collection and disposal, smoke nuisance, milk supply, meat supply, market sanitation, school sanitation, and sanitary and other conditions in almshouses, jails and police stations.

Wherever time permitted, a study was made of local housing conditions, and, in all cases, inquiry was made into the matter of the local health officer’s status in the city government, the degree of his official and popular backing, and the compensation he receives in proportion to the amount and importance of the work he is expected to do.

Now, state boards of health have considerable control, theoretically, over many details of local sanitation. However, because state boards lack funds, and because local communities are often indifferent to, or even resentful towards, proffers of help from outside, the actual local service of many state boards goes little beyond helping to check epidemics of disease after they have gotten beyond local control.

For example: There is in Minnesota, as in many other states, a law forbidding sewage pollution of public water supplies. But the State Board is very far from having the money to keep men in the field to prevent or detect violations of this law. Yet in my tours of inspection in many parts of the country, I find violations of this law, which should be one of the most sacred and most rigidly enforced on any statute book. I find many private sewers from commercial establishments and recreation grounds, and many discharging cesspools from almshouses, summer hotels and the like, which do pollute lakes and rivers and surface wells that are used for public water supplies. When numerous leading citizens of a community, on such a tour of inspection, see a thing of this kind with their own eyes, I have hardly known a case when the state law is not speedily invoked for local protection, and the state board more than willing to act. (I sometimes find that the state board has known the condition, but has been unable to get local co-operation for the city’s own protection.)

The defects in public sanitation surrounding the water sup ply of cities are numerous and often most surprising. For example, the citizens of a certain city exempted their water supply from suspicion, notwithstanding typhoid fever was endemic, because the water flowed from artesian wells more than a thousand feet deep. A visit of our party to the wells revealed the fact that the water from the several wells was collected, for pumping service, into a “reservoir,” and this reservoir was an old surface well in the midst of twelve un-skewered residence blocks! That condition was speedily remedied after it was described at a citizens’ mass meeting, and all who had visited the wells with me were, of course, prepared to confirm the facts. All the conditions, good and bad, noted in these inspections, are given out thus to the people direct at the mass meetings at the end of each campaign, and this, I as sure you, is a vastly different thing from simply filing a written report to be pigeonholed in some official desk. A written report follows, however, in due time, as a tangible basis for constructive action.

A personal study of the sewered and unsewered areas of  a city often creates a needed public sentiment, both for the extension of the system to unsewered areas and for requiring all property owners within reach of sewers to connect and to totally abolish the offensive, soil-polluting, fly-breeding outdoor closet.

Other features of the out-door inspection are: A study of street-cleaning methods, as to cost, efficiency and convenience of the people; a leisurely tour of the down-town alleys, which often reveals an embarrassing amount of bad public house keeping, and a simply appalling disregard for fire risks; a study of the garbage collection, or the lack of especially in the business districts and the poorer residence districts, and an investigation of the kind of wagons and cans used, and how they are cleaned, and what the final disposition of garbage, manure and other waste materials; an investigation of some of the factories, power houses, laundries, etc., which make the greatest smoke nuisance, followed by an object lesson, possible, in some plants that have done away with smoke, to their own advantage.

When we come to the food supply, the milk studied in the dairy barns, milk houses, milk wagons and creameries the meat in the slaughter houses, meat markets and sausage rooms; the other foods in the inner and under-side of bakeries, ice cream and candy kitchens, groceries and restaurants. The women thus learn how to inspect these places, and what are proper and reasonable standards of construction and sanitation. They are taught the use of score-card, and how to inaugurate permanent system of inspections which will place all dealers reaching certain percentage upon the housekeepers’ “white list” of recommended establishments. This a method of public education which has proved most effective in several of the smaller cities. The women find how little protection the state dairy and pure food law really affords them, as rule, and are ready and able to take the matter largely into their own hands.

School house sanitation is something which state boards are supposed to have more or less control of, since the law often gives them the right to pass upon school house plans before the buildings are erected. But, as rule, they are unable to send inspectors to see whether their suggestions have been adopted and the construction, heating, lighting, seating, plumbing, ventilation and fire protection of some of even the new school buildings — to say nothing of the old ones — sugests that state boards of health could not have been consulted or heeded. In no part of the work are the women more interested than in the study of the school houses. And the almshouses and jails have disclosed to the women many conditions which have led them to undertake radical improvements and to wish to enter upon a personal ministry to the unfortunate “forgotten people,” especially, in the almshouses.

When the question of housing is taken up, it is surprising to find how even the small city will often disclose serious housing evils, and how many cities grow from little to big, apparently in total indifference to housing evils which could so easily have been prevented, but can only with much difficulty be cured. In no relation is it quite so vital to “know your city” and know it early and well, as in relation to the housing of the people.

The question of public health administration, both in city and state, is largely a question of dollars and cents. Club women are quick to see that even the best and most ambitious state board cannot do very much if there is not money for a proper laboratory and for the work of collecting vital statistics, and for travelling inspectors and for expert service in the many lines of examination and research and precaution; all the necessary measures of preventive medicine which might forestall many epidemics so expensive of both money and human life. I am glad to say that, following our state-wide campaign in Kentucky, the legislature, according to the report of the State Board of Health, made in one year more advances in sanitary legislation and money appropriation to carry it out, than had been made in all the thirty years before.

I have not been able to more than touch in a passing manner upon the various phases of co-operation carried out be tween the state boards and state federations in Kentucky and Minnesota. In the few minutes remaining to me I want to go somewhat more into detail about an instance of co-operation between these two bodies in my own State of Michigan. It ‘is the first instance in which I had part; it is the one which has led furthest; and it has developed into a vital national issue to which I wish to entreat your earnest attention tonight.

More than ten years ago I became chairman of the committee on household economics in the State Federation of Women’s Clubs in Michigan, and in outlining a course of “Studies in Housekeeping,” I was led to look into the local milk supply and meat supply of my own city. I found here, particularly in the slaughter houses around about Kalamzoo, a disgraceful condition — but I hasten to say, no more dis graceful than I usually find in the environs of any city or town which has not risen to the necessity of adequate meat inspection. The slaughter houses around Kalamazoo were filthy, revolting, indescribable. And not only the horrible filth of sheds, utensils and surroundings, and the persons and clothing of those doing the work. There was also a total lack of inspection of the animals and carcasses, with the result that any kind of a man could kill any condition of animal in any kind of a place, strip and cut away evidences of disease and offer the meat for sale in our markets; and the same was, and true of most cities in our country today.

At this time Michigan, ten years ago, the State Federation was much interested in the disclosures the State Board of Health, also. The latter organization asked me to present this matter in detail at their annual meeting, and did so. A committee was appointed to co-operate in securing reform. Meantime, found, in an effort to incite local action in my own and other cities in our state, that general enabling act was needed, to allow all cities and villages to exclude from their limits the meat from slaughterhouses that were not licensed, inspected and regulated, according to local ordinance under this general state law. After much study, and with the aid of lawyer, drafted this enabling act, and with considerable difficulty we succeeded in getting on the statute books of the State. The State Board of Health had endorsed the bill and at its request model meat inspection ordinance was framed, which also received official indorsement and was sent out to inquiring cities over the State and in other states.

Now, during all this time, and up to something over six years ago, while was very critical of the products of the uninspected local slaughter houses, had entire confidence in the high pretensions of federal meat inspection. was advising people to purchase only meat with the stamp “U.S. Inspected and Passed.” until such time as their local butchers would clean up and submit to inspection. But in the winter of 1905 and 1906, from learning of criticisms of foreign medical experts upon our inspection, began to study into myself not merely the inspection as carried on in the great packing houses, but the law, and the “Rules and Regulations” by which the Department of Agriculture assumed to administer the law.

You may be somewhat familiar with the facts given in my testimony at the recent federal meat inspection hearing in Congress, before the House Committee on Expenditures in the Department of Agriculture. If so, you already know that I have there stated under oath my belief that the legend “U.S. Inspected and Passed” is no guarantee that the meat so stamped as required under the terms of the law, “sound, healthful, wholesome, and fit for human food.”

We are talking much of the need of federal health serv ice. think one of the strongest arguments that thereby the meat inspection service of our country might be lifted out of the Bureau of Animal Industry and the Department of Agriculture and confided to non-commercial and non-partisan service which would give us the thing which we sought to gain for ourselves in the meat inspection legislation following the expose of 1906.

Prior to 1906, our meat inspection laws were frankly commercial; they were for the sake of gaining the European market for the products of our great packing houses. But 1906, following the disclosures of “The Jungle,” Congress enacted law which was supposed to be going to protect American citizens; and for the sake of this protection,Congress voted fixed annual appropriation of $3,000,000, which the Department of Agriculture now seeking to have in creased to $4,000,000.

Now wish to state that my testimony on the subject of federal meat inspection, covering four sessions of the Committee, printed as public document, and will be glad to send copy to any person practically interested. Tonight can only touch on three or four facts out of great number brought out in the testimony; the first of which that the published regulations for federal meat inspection authorize the passing of the carcasses of animals afflicted with such diseases as tuberculosis, hog cholera and actinomycosis in several parts or organs at once. You, perhaps, think of “localized tuberculosis” as tuberculosis limited to one small area in the body. Here the present meat inspection definition of “localized tuberculosis,” which does not hinder the carcass from being passed for food:

“By localized tuberculosis understood tuberculosis limited to single or several parts or organs of the body  without evidence of recent invasion of numerous bacilli into the systemic circulation.”

On the same day, April 1, 1908, on which the regulations containing this definition were passed, a separate circular of instructions was issued, to inspectors only, which to a great degree obliterated the significance of the fine drawn distinctions between “localized” and “generalized” tuberculosis, and specifically authorized the passing of meat which by the terms of the “Regulations” would have had to be condemned.

Also in my sworn testimony I have produced several instances of “decisions” upon carcasses, signed and approved by A.D. Melvin, Chief of the Bureau of Animal Industry, in which cows and hogs with tuberculosis in many parts of the body, including a case of “several small nodules, size of walnut, in each lung,” are passed for food; not for lard, but the carcasses to be stamped “U.S. Inspected and Passed.” This is a part of what is done in the Chicago “Summer School of Instruction” for veterinary meat inspectors in charge of the packing house stations all over the counttry. It is something carefully concealed from the American people.

But all the time, throughout the year, instructions are issued to the inspectors, which are carefully kept from the knowledge of the people, inspectors being warned against “giving or showing copies to outsiders,” for which offense they “will be severely dealt with.” For example, the published Regulations say that any organ or part of a carcass which is the seat of a tumor, malignant or benign, shall be condemned, and that the head and tongue of all lumpy-jawed cattle shall be condemned. But secret instructions authorize inspectors to cut out mild ulcers from lumpy-jawed tongues, and pass the tongues; and a veterinary inspector who followed me on the witness stand told of being required to cut such deep ulcers out of tongues that great gaping holes resulted. And, not withstanding the diagnosis between benign and malignant tumors (cancers) is in certain instances a difficult thing, the secret instructions authorize the cutting out of “benign” tumors and passing the affected organs! The same of livers and other organs invested with flukes (worms by no means microscopic), though the “Regulations” condemn such affected organs; but they are passed for food by the secret instructions to inspectors.

But all these meat delicacies are reserved for home consumption. A secret circular relates that 580 cases of ox and lamb livers shipped from the United States to London were condemned by the London port officers on the ground that twenty per cent, of the lamb livers and thirty per cent, of the ox livers had had sections removed from them, and this was held to be evidence that they were diseased. The head of our federal meat inspection service then says:

“In view of these circumstances, bureau inspectors are directed in future not to certify for export edible organs, such as livers, which have been mutilated, or from which portions have been removed.” (Italics mine.)

So Americans eat not only their own proportion of livers and tongues and other organs and parts’ from which tumors and abscesses and worms have been cut out, but they eat the portion that is eliminated from all the packers’ export trade as well.

England, Germany, France, Switzerland and even Mexico and some South American countries know better than to trust our inspection. They require special safe guards and guarantees, and get them, too. Germany and Francerequire all fresh carcasses to be shipped with lungs and other organs, and many tell-tale glands, intact. What they do in fact, to re-inspect these carcasses bearing the stamp “U. S. Inspected and Passed.” England requires all hogcarcasses to be entirely free from traces of disease, and the glands that prove must be left in place. Switzerland has very stringent rules about American meat. Mexico and Argentina require all shipments of our meat to be vised (that is, “ok’d”) by consular representative before can be shipped from the American packing house. All this means that slaughtering and dressing of carcasses for these and other countries must be done in special way and that means that the best animals would be selected for slaughter — and the worst left for Americans. Americans seem to be about the only civilized people on the face of the earth who will eat what set before them and ask no questions Yes, and pay $3,000,000 year for the privilege of getting the leavings rejected by the rest of the world.

And moreover, if you will read this testimony, you will learn that the lowering of standards for federal meat inspection (an outrageous and illegal proceeding) has been largely accomplished as the direct and demonstrable result of solicitation of the American Meat Packers’ Association; and that known repeated flagrant violations by the packers of the most vital provisions of the law and the regulations go uncorrected and almost unrebuked.

This is not merely a hygienic evil; it is an outrage upon national dignity and self-respect. I cannot believe that the patriotic women of the country, knowing about will suffer to continue. appeal especially to California and the other free Western states where the women have the vote; and suggest that remedy at hand through cooperation between the State Federation of Women’s Clubs and the State Board of Health. Suppose the great State of California, for example, could be brought to decision that meat which not good enough for the people of Germany and Mexico not good enough for the people of California sup pose she should refuse to let the carcasses and products and mutilated fragments of diseased animals cross over into her territory, even though bearing the legend “U.S. Inspected and Passed;” — why, California, alone, could protect herself and at the same time inaugurate reform which would sweep the United States free of tainted meat and no less tainted federal meat inspection service.

Women are the housekeepers and the purchasers of food. They certainly have the key to the situation in their hands. And they can effectually declare that, while foreign trade is a good thing for our nation, pure food at home vastly better thing, and thing they propose to have. This direct issue between “big business” and the homes and lives of our people. The more foreign trade we have which reserves diseased meat for home consumption, the more of our own citizens will go down, not under two miles of water, but under six feet of earth.

Here vital, pressing issue for which entreat the earnest consideration and energetic action of the federated clubs all over the country. In many states believe they could obtain the co-operation of their state boards of health in doing away with condition which at once moral disgrace to our nation and great menace to the public health.

 

 

 Source: Co-operation with State Boards of Health: An Address on “President’s Evening,” General Federation of Women’s Clubs, pp. 3-12.